Magnetic resonance in preterm and term newborns: 1H-spectroscopy in developing human brain.

Localized proton magnetic resonance spectra were recorded from human cerebellum in vivo with a 1.5-T magnet. The spectra from healthy adults and preterm and term babies showed resonances from N-acetylaspartate, creatine and phosphocreatine, choline-containing compounds such as phosphocholine and glycerophosphocholine, taurine, and inositol. The age-dependent changes of in vivo molar concentrations of N-acetylaspartate, choline, taurine, and inositol were estimated in preterm babies, babies at term, and adults. The range of postconceptional age in the studied babies was 31 to 45 wk. Taking the biochemically measured creatine concentrations in age-corresponding autopsy material as an internal standard, the in vivo concentrations of the other metabolites were calculated from the proton spectra. N-acetylaspartate showed an increase from 1.9 mM in preterm babies to 3.1 mM in term babies and to 6.5 mM in adult brain. Taurine was noted to increase from 1.1 mM in preterm infants to 2.3 mM in term infants and did not decrease significantly in adult brain. Choline and inositol concentrations did not change significantly throughout the studied age groups. These new data on in vivo, localized 1H-spectroscopy show that it is a sensitive method for studying early metabolic brain development in humans.     

Nutritional support of the multiple trauma patient

This report presents a brief review of currently relevant aspects of the parenteral nutritional support of the multiple trauma patient in intensive care. The decisive factors governing selection and application of an individually devised program of parenteral nutrition are the multiple trauma patient's energy turnover and nitrogen losses on the one hand, and the tolerance limits and viability of the traumatized organism on the other. It is possible nowadays to provide situation-adapted nutritional support corresponding to the individual requirements of a seriously injured patient. However, further detailed studies are still necessary to come up with more definite answers to questions regarding requirement levels, turnover, and tolerance of the substrates applied in critical metabolic situations. This aside, adequate nutritional therapy at present represents without a doubt an integral feature of any long-term post-trauma therapeutic program.     

189. Isoelastische Prothesen des Ellbogengelenkes

Zusammenfassung Die Indikation zum künstlichen Gelenkersatz des Ellbogens muß auf die Fälle beschränkt bleiben, in denen alternativ nur ausgedehnte Resektionsplastiken oder Versteifungen möglich sind. Das zentrale Problem dieser Prothesen ist die Lockerung, da die Verankerung durch die langen Hebelarme der oberen Extremität erheblichen Belastungen ausgesetzt ist. Die Isoelastische Prothese des Ellbogengelenkes stellt eine interessante Neuentwicklung dar, da sie bei großflächigem Prothesen-Knochenkontakt zementfrei implantiert werden kann. Prothesentyp und Implantationstechnik werden anhand repräsentativer Fälle vorgestellt.     

Safety of Bioelectrical Impedance Analysis in Patients Equipped With Implantable Cardioverter Defibrillators

Background. Current guidelines warn of potential electromagnetic interferences (EMI) when using bioelectrical impedance analysis (BIA) to measure body composition in patients equipped with implantable cardioverter‐defibrillators (ICDs). We aimed to test the occurrence of EMI in a setting where this risk was experimentally maximized. Materials and Methods. Outpatients scheduled for routine ICD controls simultaneously underwent a BIA measurement using an electrical current of 0.8 mAmp at frequencies from 5–100 kHz. ICD sensitivity levels were set to maximum levels while therapies were temporarily inactivated. The device electrograms were monitored in real time to detect sensed and/or visible EMI during BIA measurement. Results. A total of 63 patients equipped with single‐chamber (n = 13), dual‐chamber (n = 18), or biventricular (n = 32) ICDs from 5 major manufacturers were included. No EMI were detected by the ICDs in these patients, nor were any artifacts visualized during real‐time electrogram recordings. Conclusion. BIA can be safely performed in patients equipped with ICDs without cardiac monitoring. Current guidelines should be updated accordingly.     

Krill Products: An Overview of Animal Studies

Many animal studies have been performed with krill oil (KO) and this review aims to summarize their findings and give insight into the mechanism of action of KO. Animal models that have been used in studies with KO include obesity, depression, myocardial infarction, chronic low-grade and ulcerative inflammation and are described in detail. Moreover, studies with KO in the form of krill powder (KP) and krill protein concentrate (KPC) as a mix of lipids and proteins are mentioned and compared to the effects of KO. In addition, differences in tissue uptake of the long-chain omega-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), when delivered in either phospholipid or triglyceride form, are addressed and the differential impact the delivery form has on gene expression profiles is explained. In our outlook, we try to highlight the potential of KO and KP supplementation in clinical settings and discuss health segments that have a high potential of showing krill product specific health benefits and warrant further clinical investigations.     

Ultrastructural and molecular confirmation of the trichodysplasia spinulosa‐associated polyomavirus in biopsies of patients with trichodysplasia spinulosa

Trichodysplasia spinulosa (TS) is a rare and only recently characterized cutaneous disease occurring in immunocompromised patients. The disease is characterized by spiny follicular papules on clinical examination and by the presence of viral inclusions at ultrastructural examination. In the last year, this virus has been identified as a new member of the polyomavirus family and designated as TS‐associated polyomavirus (TSPyV). We report two organ transplant patients with this disease in which we were able to identify the TSPyV at ultrastructural and molecular level from formalin‐fixed paraffin‐embedded biopsies of lesional skin. Similar to prior described cases, the patients presented with follicular papules which were concentrated on the central face and associated with alopecia. Histopathology of both cases showed dilated follicular infundibula plugged with cornified eosinophilic cells containing large trichohyaline granules. Transmission electron microscopy on paraffin‐embedded tissue in case 1 showed 28‐nm intracellular viral particles morphologically consistent with polyoma virus. For both cases the presence of TSPyV was confirmed by polymerase chain reaction with virus‐specific primers followed by identification by direct sequencing. These two cases show the presence of the newly described TSPyV in TS further establishing its association with this distinctive disease.     

Direct determination of selenium in human serum by inductively coupled plasma-collision cell-mass spectrometry.

BACKGROUND: Selenium status in humans depends on nutritional intake. To facilitate a future monitoring study with a large number of samples, an inductively coupled plasma mass spectrometry (ICP-MS) analysis method including collision cell technology was developed for the direct determination of selenium in human serum. METHODS: Serum samples were diluted (1:15 v/v) with an aqueous solution containing 2-propanol, EDTA(NH(4))(2), ammonia and Triton X-100. Isotope dilution was used as the calibration method, evaluating the (78)Se/(82)Se ratio. Interference by (81)BrH(+) was corrected mathematically. Nebuliser blockage was prevented by sample centrifugation and filtration of the wash solution. Method validation was carried out using certified and spiked human sera. RESULTS: All values obtained for the accuracy tests were either within the certified ranges or showed recovery between 100.9% and 104.7%. Further results were relative standard deviation of 2.0% for repeatability and 3.0% for between-run precision, a limit of detection of 0.5 mug/L and a limit of quantification of 1.1 microg/L. CONCLUSIONS: The benefits of the new method are high accuracy combined with low sample consumption and fast sample throughput.